Miranda Edison D, Fernandez Trokhimtchouk Tatiana, Flores Luis F, Morillo Cox Álvaro, Negrete Jose R
Internal Medicine, Universidad Internacional del Ecuador, Axxis Hospital, Quito, ECU.
General Surgery, Universidad Internacional del Ecuador, Axxis Hospital, Quito, ECU.
Cureus. 2023 Apr 25;15(4):e38098. doi: 10.7759/cureus.38098. eCollection 2023 Apr.
Gastrointestinal stromal tumors (GISTs) are a common type of soft tissue sarcoma that originates from the interstitial cells of Cajal in the gastrointestinal (GI) tract. These tumors usually affect people above 50 years of age and can be difficult to diagnose, as symptoms can be vague and nonspecific, with some patients remaining asymptomatic. Early diagnosis and treatment are crucial because GISTs can be aggressive and may metastasize. We present a case of a 74-year-old man who presented to our hospital with GI bleeding and anemia. Despite initial investigations, the source of bleeding was not identified until capsule endoscopy and then balloon enteroscopy revealed an ulcerated mass in the jejunum. The tumor was successfully removed using a minimally invasive laparoscopic approach, and the histopathologic report confirmed the diagnosis of GIST. The patient had an uneventful postoperative course. This case highlights the importance of considering GISTs in the differential diagnosis of obscure GI bleeding. A multidisciplinary approach is essential to ensure the best outcomes for these patients. Additionally, the use of minimally invasive surgery should be considered whenever possible to minimize postoperative complications and promote faster recovery.
胃肠道间质瘤(GISTs)是一种常见的软组织肉瘤,起源于胃肠道(GI)道的 Cajal 间质细胞。这些肿瘤通常影响 50 岁以上的人群,并且可能难以诊断,因为症状可能模糊且不具特异性,一些患者没有症状。早期诊断和治疗至关重要,因为 GISTs 可能具有侵袭性并可能发生转移。我们报告一例 74 岁男性患者,他因胃肠道出血和贫血前来我院就诊。尽管进行了初步检查,但直到胶囊内镜检查,然后气囊小肠镜检查发现空肠有一个溃疡肿块,才确定出血来源。使用微创腹腔镜手术成功切除肿瘤,组织病理学报告证实为 GIST 诊断。患者术后恢复顺利。该病例强调了在不明原因胃肠道出血的鉴别诊断中考虑 GISTs 的重要性。多学科方法对于确保这些患者获得最佳治疗效果至关重要。此外,应尽可能考虑使用微创手术,以尽量减少术后并发症并促进更快康复。